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Home My WebLink About2011-00238 - sewer reconnect CITY OF ORONO PERMIT NO.: 2011-00238 '' ' ' 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 04/22/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 4415 NORTH SHORE DR PIN : 07-117-23-43-0017 LEGAL DESC : SAGA HILL REVISED : LOT 000 BLOCK 018 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE ��`CONNECTION NOTE: SEWER CONNECTION-PIPE SIZE-4" -MATERIAL-SCHEDULE 40 � APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WESTONKA SEWER&WATER STATE SURCHARGE SEWER&WATER 5.00 6501 CO.RD 15 TOTAL 55.00 MOLJND,MN 55364 (952)472-4959 Minnesota State License#: 1804 OWNER TWOMEY,DAREA&CHRIS 150 2ND STREET NE MINNEAPOLIS,MN 55413- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate � permits. All provisions of laws and ordinances goveming this type of work • shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if consWction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for suring all required inspections are ' requested in conform i e State Building Code.1'his permit may be revoke ti r d se. /�a / (� ��-2 /�� A licant Permrtee Signature Date I By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. t � ! � -- Ffl CI USE ONLY �/ O�Q�,� City of Orono Date Recetved.�: � Femut# ��II—� : �O P.O.Box 66 ' ° 2750 Kelley Parkway ❑In-House SAC Determuiarion Form Completed Crystal Bay,MN 55323 � `' �o� (952)249-4600 Approved By(If'Required): CITY OF ORONO—SEWER&WATER/GENERAL PERNIIT (*Note:Some permits may require approval by the Building O�cial and/or Public Works Department'") (ALL PERMITS- Mav be subiect to furt6er revtew and mav not be issued when the aoalicatian is receivedl GENERAL IN�ORMATION 1. You may apply for utility permits by mail or in person at the City offices. 2. Mailed in applications are subject to the postage and handling fee shown below. Permit cards will be sent by return mail within 2 business days, 3. Permits are not valid until you receive a permit card. 4. Work must not begin unless the permit card is available on the job site. 5. Utility connection permits may be issued to licensed contractors only. 6. Contact the Public Warks Department(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works Department. Issuance of a permit does not grant this approval. 7. All work must be done in accordance with Staxe Code requirements. 8. All work must be inspected before it is covered. Call(952)249-4600,24+hour aotice required. TYPE OF'PERIVIIT ' Check A11 That A 1 �esidential(May Require Approval) ❑Commercial(Approval Required) '�Tew Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect � ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: _`[� [) �v "� J `�� 1 � ,�---� Owner: 1 l� �o v�P Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information:; Contractor: W��S S!� Contact Person: F°�`� �� Address: �� S State License#: � �`�to City: ��l°� Zip:��Expiration Date: Phone: �oZ�?�-C�� Alternate Phone: ��Z" ?��-g��S �� , 4 : DE`�'E�tNIT�1TNjG P�RMIT�E�S � ❑SAC Charge(2011 Rate=$2,230.00) $ (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono City Staff can determine if applicable) (If not prepaid,a sewer connection permit will not be issued) �Sewer Conne t on/Disconnect/Repair($50.00/Per Stub) $ Pipe size�inches;material�Schd 40 air tested; cast iron ❑Water Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; copper ❑Water Availability For Future Hook-Up to Water($50.00) $ Water Availabilitv Exnlanation: Contractor installed]ine to inside of house for future hook-up. This line will be inspected by the Public Works Department. Required Before Water Connection Permit is Issued: 1. Issue Water Meter&Horn Permit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Connection Permit: 1. Collect Permit Fee&Issue Water Connection Permit 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ 5.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ADDITIONAL INFORMATION'-WATER METERS' ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a sebarate permit. ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon completion of ineter installation. The undersigned hereby applies to the City of Orono for issuance of a Utility Permit,agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota,and certifies that a11 s en de on this application are,true and correct. Applicant. Date:�� DATE TIME V CITY OF ORONO CALLED IN v;o 0 INSPECTION OTI E SCHEDULED �L_L L PERMIT NO. ��- o �a 3 g COMPLETED ADDRESS ��/!� � -S � OWNER TELEPHONE NO. CONTRACTOR ��'sTb.J�i} >; DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB � ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL M �SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE � � ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ik \ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI �V� SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET U:_YES_NO � COMMENTS: u � W a � J O � � � A� � - � W � Q � z W � W � j d W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CAL�TOARRANGEACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 Owner/Contractor Inspector. White C pyllnspector's File Canary CopylSite Notice